Polkinghorne et al studied the effect of vascular access in incident hemodialysis patients on all-cause mortality using multivariate analysis.(16) In this adjusted analysis, catheter use and AVGs were associated with significant excess mortality. Compared to AVFs, catheters were associated with a 3.3-fold higher and AVGs with a 1.6-fold higher all-cause mortality after 120 days. However, the authors speculate that, in part, this may due to the higher risk of infections. In fact the risk of infectious death was 1.7-fold higher with AVGs, and 2.7 fold higher with catheters. The risk of the type of vascular access with inflammation, independent of infection, is unknown.